Sandin Kekic, OTD, OTR/L

Individual provider Active NPI Occupational Therapist · Grand Rapids, MI

NPI 1376254458 · NPPES record last updated Mar 10, 2023

Key facts

NPI
1376254458
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5201013191 (MI)
Practice address
2251 E Paris Ave SE
Grand Rapids, MI 49546-2431
Phone
(616) 447-7799
NPI assigned
Dec 8, 2022
Sex
Male
Sole proprietor
Yes

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Center, Inc. (51 clinicians)

Practice addresses (Care Compare)

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100 (group)
Quality
93.09
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230209000859 MI Practitioner - Occupational Therapist in Private Practice 4880066356 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5201013191MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay, Inc. Current
since Dec 9, 2022
Accepting new patients
Family Health Center Inc Current
since Mar 1, 2023
Accepting new patients
Family Health Center Inc Current
since Mar 1, 2023
Accepting new patients

Locations

2251 East Paris Ave SE
Grand Rapids, MI 49546
Phone (616) 447-7799

117 W Paterson St
Kalamazoo, MI 49007

505 E Alcott St
Kalamazoo, MI 49001
Phone 2693492641 ext. 715

570 E Division St
Rockford, MI 49341
Phone (616) 447-7799

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201013191 MI Yes

Addresses

Primary practice location

2251 E Paris Ave SE
Grand Rapids, MI 49546-2431

Mailing address

201 Fulton St W
Grand Rapids, MI 49503-6201

Other practice location 1

570 E Division St
Rockford, MI 49341-1323
Phone (616) 447-7799

Other providers in Grand Rapids, MI

All providers in Grand Rapids, MI · Occupational Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.